Poor Accuracy of Methods Currently Used to Determine Umbilical Catheter Insertion Length

Verheij, Gerdina H.; Pas, Arjan B. te; Witlox, Ruben S G M; Smits-Wintjens, Vivianne E.H.J.; Walther, Frans J.; Lopriore, Enrico

doi:10.1155/2010/873167

Cited by 48 publications

(43 citation statements)

References 21 publications

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“…In the study by Verheij et al 8 where they considered T1-T11 as the correct site of insertion for the umbilical arterial catheter found that by Dunn's formula 6 the accuracy of insertion was 63% and using Shukla's formula 7 the accuracy was significantly (P<0.05) better at 87%. In spite of taking the normal from T1, the catheters were over inserted in rest of the children.…”

Section: Discussionmentioning

confidence: 99%

“…8 The need for a simple and reliable common formula to predict the length of the catheter to be inserted in preterm and term babies is lacking. In the study by Wright et al 3 only <1500 g babies were included in the study and the study group was 74 neonates as compared with our study where 26 (26.3%) were term and the rest (n ¼ 73) were preterm (Figure 2).…”

Section: Discussionmentioning

confidence: 99%

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Umbilical arterial catheter insertion length: in quest of a universal formula

Kumar

Nayak

et al. 2011

J Perinatol

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Objective: The study was aimed at comparing the accuracy in length of insertion of umbilical arterial catheter in all new born groups stratified according to weight, by using two different methods, that is, Wright et al./ Case (Group I): (4 Â Body wt (BW) (kg)) þ 7; Shukla et al./Control (Group II): (3 Â BW (kg)) þ 9.Study Design: It was a randomized open label case control study in a Level III tertiary level Neonatal Intensive Care Unit over 9 months.Result: The babies in both the groups were similar in relation to weight, gender, prematurity and weight subgroups. Under insertion was seen in 8% (4/50) of babies in group I and over insertion was seen in group II where it was 32.6% (16/49). There was a reduction of 82% abnormal insertions and repositioning by using the Wright's formula as compared with the Shukla's formula in preterm babies. Statistically significant reduction in repositioning was seen in all babies <1500 g in Group I and under insertion seen in 8% of babies in group I did not attain statistical significance (P ¼ 0.34).Conclusions: There is no universal formula, which gives the accurate length of placement of an umbilical arterial catheter, but Wright's formula comes closer in neonates with different weight sub groups.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Umbilical arterial catheter insertion length: in quest of a universal formula

Kumar

Nayak

et al. 2011

J Perinatol

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“…The most appropriate position for an umbilical venous catheter tip position is considered as the junction of the inferior vena cava and right atrium (6,7,(9)(10)(11). This regions corresponds to the T9-10 range on anterior-posterior chest radiographs.…”

Section: Discussionmentioning

confidence: 99%

“…The position of placement of the catheters, which proceeded along the vertebral column and were specified with anterior-posterior chest radiograph, was considered appropriate when it was between the 9th and 10th thoracic vertebrae (T9-10), "too high" when it was above T9 and "too low" when it was below T10 (6,7). Catheters that directed to the portal or splenic veins were defined as having an abnormal position.…”

Section: Methodsmentioning

confidence: 99%

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Comparison of methods and formulas used in umbilical venous catheter placement

Mutlu¹,

Pariltan²,

Aslan³

et al. 2017

Turk Pediatri Ars

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Aim: Central venous access is frequently provided by way of umbilical venous catheter placement in critically ill newborns. This study compared the methods of Dunn, Shukla-Ferrara, and Revised Shukla-Ferrara in determining the appropriate insertion length of umbilical vein catheters. Material and Methods:This prospective observational study was carried out in 121 newborns with umbilical venous catheter, group 1 (n=41) used Dunn method, group 2 (n=40) used the Shukla-Ferrara formula, and group 3 used revised Shukla-Ferrara formula (n=40). Catheter tip position was evaluated with an anterior-posterior chest radiograph after insertion of the umbilical venous catheter. The ideal position for the umbilical venous catheter was defined as the catheter tip being visible between the 9 th and 10 th thoracic vertebrae on an anterior-posterior chest radiograph. The position of the umbilical venous catheter was considered too high if the tip of the catheter was higher than the 9 th thoracic vertebra and too low if the tip was below the 10 th thoracic vertebra. The following data were collected: appropriate, inappropriate (low, high) placement, and complications of umbilical venous catheterization. Results:In the Shukla-Ferrara group, 53% (17/32) of umbilical venous catheters were placed directly in the appropriate position, compared with 40% (12/30) in the revised Shukla-Ferrara group and 38% (11/29) in the Dunn method group. Umbilical venous catheter-related complications developed in two patients, thrombus in one, and catheter-related blood stream infection in the other. Conclusions:This study showed that the Shukla-Ferrara formula is more accurate in predicting the insertion length for umbilical venous catheters, though statistical significance was not found. Further studies with larger samples are needed on this topic. (Turk Pediatri Ars 2017; 52: 35-42)

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Comparative analysis of formulae for umbilical venous catheterization depth based on birth weight

Luo,

Zheng,

Yang

et al. 2024

Pediatric Investigation

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ImportanceUmbilical venous catheterization (UVC) is a common procedure for critically ill newborn infants. The insertion depth was estimated before the procedure using various formulae.ObjectiveTo compare the accuracy of five published formulae based on birth weight (BW).MethodsThis is a secondary retrospective analysis using data collected in a previous study, in which the actual final insertion depth of UVC was recorded. Predicted insertion depths were calculated by five published formulae based on BW. Then the actual depth and predicted depth were compared. Accurate position was defined as predicted depth being within ± 10% of actual depth. The accuracy rate calculated as “(accurately positioned UVCs/ all UVCs) × 100%” and the ratio of difference calculated as “(|predicted depth − actual depth|/ actual depth)” were compared among five formulae.ResultsTotally 1298 were enrolled, with gestational age 29.8 ± 2.3 weeks and BW 1215 ± 273 g. The accuracy rates were: Tambasco formula (67.2%), Shukla formula (65.0%), JSS formula (64.4%), BW formula (48.9%), and revised Shukla formula (26.9%). Tambasco formula had the highest accuracy rate in newborns with BW ≥ 1000 g. JSS formula had the highest accuracy rate in newborns with BW<1000 g.InterpretationIt is suggested to use the Tambasco formula for estimating the UVC insertion depth for newborns, especially for those with BW ≥ 1000 g, and to apply the JSS formula for newborns with BW < 1000 g. There is no universal formula for achieving 100% accurate positioning.

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Poor Accuracy of Methods Currently Used to Determine Umbilical Catheter Insertion Length

Cited by 48 publications

References 21 publications

Umbilical arterial catheter insertion length: in quest of a universal formula

Umbilical arterial catheter insertion length: in quest of a universal formula

Comparison of methods and formulas used in umbilical venous catheter placement

Comparative analysis of formulae for umbilical venous catheterization depth based on birth weight

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